A Case of Escherichia coli Endocarditis After Hemorrhoidectomy Performed by a Herbalist

We describe the first reported case of Escherichia coli endocarditis following a hemorrhoidectomy that was performed by the patient's herbalist. With increasing frequency, patients are seeking care by those who practice alternative medicine. Physicians must become more aware of the impact and possible complications related to this practice. Prosthetic valve endocarditis ranges up to 1.5% per patient-year for mechanical mitral valves and up to 0.1% per patient-year for other valves. Although the incidence of aortic prosthetic valve endocarditis is not uncommon, the concomitant organism and its mode of bacteremia make this a most unusual case. There is a paucity of information in the literature regarding surgical complications performed by alternative medicine practitioners. To our knowledge, a case of gram-negative endocarditis as a result of hemorrhoidectomy performed by an herbalist has never been reported.